A Bayer of a Case

​A 30-year-old woman was brought in by EMS tearful and reluctant to answer questions initially. Her mother was with her and stated that the patient had been depressed and may have taken some pills in a suicide attempt. Her initial vitals on presentation were a temperature of 99.1°F, heart rate of 128 bpm, blood pressure of132/92 mm Hg, and a respiratory rate of 26 bpm. She had clear lungs and sinus tachycardia on cardiac monitoring. She admitted to having taken "a lot" of aspirin.Initial LabsCBC: WBC of 14, hemoglobin of 14 g/dL, hematocrit of 42%, platelet count of 250,000BMP: Sodium of 132 mEq/L, potassium of 4 mEq/L, Cl of 99 mEq/L, bicarbonate of 16 mEq/L, BUN of 30 mg/dL, creatinine of 1.2 mg/dL, glucose of 105 mg/dLLactate: 2.6 mmol/LSalicylate level: 62.2 mg/dLCommon Presentation of Salicylate ToxicityNausea, vomiting, gastric irritationTinnitus or hearing lossAltered mental status: confusion, agitation, somnolence, comaSeizuresHypoglycemiaTachypneaTachycardiaAcid-base disturbances: Central stimulation of the respiratory center results in hyperventilation, which leads to a respiratory alkalosis and a compensatory metabolic acidosis.Hyperthermia because of the effects intracellularly of uncoupling oxidative phosphorylationCerebral and pulmonary edemaAcute v. Chronic Salicylate IngestionAcute ingestion:Levels correlate with symptoms:30-45 mg/dL: Tinnitus and tachypnea45-60 mg/dL: Nausea and vomiting70-90 mg/dL: Tachycardia, altered mental status, and agit...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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Publication date: Available online 26 June 2019Source: Epilepsy &BehaviorAuthor(s): Mahinda Yogarajah, Marco MulaAbstractDeficits in social cognition are an increasingly recognized complication of epilepsy and contribute to the deficits in social functioning and well-being experienced by patients with epilepsy. Although there has been an increase in studies exploring the measurement and biology of social cognition in patients with epilepsy, there are relatively few examining its clinical implications. Those studies that have been published highlight that social cognitive deficits contribute to impaired quality of life ...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Source: BMJ News - Category: General Medicine Source Type: research
Conclusions Patients with longer duration of HD, male sex, and the presence of dyspepsia had higher odds to exhibit H. pylori infection. Helicobacter pylori infection did not seem to have an influence on iron deficiency or anemia severity in HD patients and does not have relation with serum hepcidin level. However, H. pylori may to be related to inflammation in HD patients.
Source: Infectious Diseases in Clinical Practice - Category: Infectious Diseases Tags: Original Articles Source Type: research
Conclusions: PHIV+ are likely to face future physical and psychological health consequences related to the functional competence challenges they face if mental health care is not made a priority in the fight against HIV.
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - Category: Infectious Diseases Tags: Clinical Science Source Type: research
Background: Falls and fall risk factors are common among people living with HIV (PLWH). We sought to identify fall risk factors among men with and without HIV. Methods: Men aged 50–75 years with (n = 279) and without HIV (n = 379) from the Bone Strength Substudy of the Multicenter AIDS Cohort Study were included. Multinomial logistic regression models identified risk factors associated with falling. Results: One hundred fourteen (41%) PLWH and 149 (39%) of uninfected men had ≥1 fall; 54 (20%) PLWH and 66 (17%) of uninfected men experienced ≥2 falls over 2 years. Five and 3% of PLWH and uninfected men, r...
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - Category: Infectious Diseases Tags: Clinical Science Source Type: research
Publication date: July 2019Source: The Lancet Haematology, Volume 6, Issue 7Author(s): Frank Bridoux, Sylvie Chevret, Jean-Paul Fermand
Source: The Lancet Haematology - Category: Hematology Source Type: research
A nationwide shortage of intravenous (IV) sodium bicarbonate required institutions to explore alternative options for urinary alkalinization for high-dose methotrexate (HDMTX). Children’s Hospital Colorado implemented a protocol utilizing oral alkalinizing agents as alternatives to intravenous sodium bicarbonate during the shortage. The purpose of this study was to determine the safety and efficacy of oral alkalinization strategies for HDMTX administration. This retrospective study was conducted at a pediatric institution and evaluated cycles of HDMTX administered with at least one dose of oral sodium bicarbonate tab...
Source: Journal of Pediatric Hematology Oncology - Category: Hematology Tags: Original Articles Source Type: research
CONCLUSION: The result suggests that the inverse association on depressive symptoms might be expected not only caffeine intake but also some other substances in coffee or factors related to coffee intake. Because of its cross-sectional design, longitudinal studies are required to confirm the present finding. PMID: 31231097 [PubMed - as supplied by publisher]
Source: Journal of Epidemiology - Category: Epidemiology Tags: J Epidemiol Source Type: research
ConclusionsHyperuricemia is a compounding factor for NAFLD, particularly in males. The severer hepatic injury observed in male NAFLD patients may be attributed to the suppression of SIRT1 signalling induced by hyperuricemia.
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
U.S. veterans with post-traumatic stress disorder (PTSD) are more likely than typical Americans to die of causes including suicide and accidental injuries, a recent study suggests.
Source: Reuters: Health - Category: Consumer Health News Tags: healthNews Source Type: news
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